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Duke  university  Libraries 

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Conf  Pam  l2mo  #143 


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^ori-^  .  ^  Ic^T^t.  SiTRGEON  General's  Office, 

'**  Richmond.  April  25,  1863. 

The  frequency  Avitli  which  Reports  of  Sick  and  AVoiinded  reach  this 
oflBce  incomplete  and  defective,  and  wholly  unsuited  to  establish  accu- 
rate and  reliable  statistics  couctrning  the  prevfilcncc;  of  disease  through- 
out the  army,  suggests  for  the  future  guidance  of  Medical  Officers,  th** 
following  Instructions  relative  to  their  preparation: 

I.  Ill  every  case  the.  spaces  left  in  blank  should  be  appropriately  tilled; 
not  omitting  to  designate,  in  addition  to  the  number  of  the  Regiment, 
liattaiion  or  Battery,  the  State  in  which  it  was  raised,  or  if  a  I'ost,  Hos- 
pital or  Camp,  the  County  and  State  in  Avhich  it  is  situated. 

II.  Only  cases  of  disease  occurring  during  the  month  or  quarter,  should 
be  admitted  into  the  body«)f  the  Report ;  tho.^e  remaining  over  from  last 
Report,  will  be  exhibited  in  the  "General  Summary,"  in  the  columns 
'•Remaining  last  Quarterly  or  Monthly  Report." 

III.  All  deaths  during  the  j)eriod  covered  by  the  Report,  whether  oc- 
curring among  those  taken  #ick  or  received  into  hospital  during  that  or 
a  previous  period,  will  be  entered  on  its  face,  opposite;  their  appropriate, 
diseases,  and  recorded  on  the  back  of  the  Report;  but  deaths  occurring 
among  those  not  on  the  Sick  Report,  as  when  killed  in  battle,  or  in  any 
other  violent  and  sudden  manner,  will  alone  be  recorded  on  the  back  of 
the. Report,  "separated  from  the  others  by  a  double  line  drawn  across 
the  page." 

IV.  New  diseases  supervening  upon  those  already  registered,  will  be 
embraced  in  the  body  of  the  Report,  and  the  luimber  of  such  supervening 
cases  noted  on  tVie  margin.  These  subtracted  from  the  whole  number  of 
cases,  will  indicate  the  actual  number  of  patients  to  bt;  accounted  for 
("Taken  SicJc  during  the  Mouth  or  Quarter"),  and  which,  when  added 
to  those  "Remaining  from  last  Report,"  will  c«mstitut«  the  "Aggregate" 
of  the  General  Summary. 

V.  In  Quarterly  Reports  properly  prepared,  the  tigures  in  the  coluuiUf« 
headed,  respectively,  "Total  by  each  Disease,"  and  "'Jjjytal  by  each 
Class,"  will  correspond;  and  these  again,  or  the  %um  "Total"  in  the 
Monthly  Reports,  provided  there  are  no  "  Supervening  Cases,"  or  if  there 
are,  alter  tlit;ir  deduction  from  the  others,  with  the  figures  in  the  column 
of  the  General  Summary  "Taken  Sick  during  the  Month  or  Quarter." 
So  too  the  deaths  entered  ijj  the  body  of  the  Report,  will  correspond  with 


the  number  in  the  General  Summary,  and  with  tlic  number  recorded  by 
name  on  the  back  of  the  Report,  above  the  "double  lino"  mentioned  in 
paragraph  III;  and  the  Discharges  Tix  the  General  Summary  will  like- 
wise correspond  with  the  number  recorded  by  name  above  this  "double 
line."  And  finally,  if  correct,  the  number  still  "Kemaining  Sick  and 
Convalescent,]'  will  bo  shown  by  adding  together  the  number  disposed  of 
in  the  several  columns  headed  "Sent  to  General  Hospital,"  "Kcturned  to 
Duty,"  "On  Furlough,"  "Discharged,"  "Deserted,"  and  "Died,"  and 
subtracting  the  same  from  the  "Aggregate;"  the  result  corresponding 
with  the  number  actually  "Remaining  Sick  and  Convalescent." 

VI.  No  cases  of  disease  other  than  those  occurring  among  oflficers  and 
soldiers,  will  be  embraced  in  these  reports.  Any  other  cases,  if  noticed, 
will  be  reported  separately. 

VII.  In  the  General  Summary,  the  "mean  strength"  for  the  month 
is  estimated,  by  adding  together  the  number  ^f  officers  and  men  present 
&t  stated  periods  of  the  month,  and  dividing  the  result  by  the  number  of 
such  periods;  and  for  the  quarter,  by  summing  up  the  "  mean  strength" 
for  each  month  of  the  quarter,  and  dividing  by  the  number  of  months.* 

VIII.  The  "ratio  of  cases  per  thousaiK^of  mean  strength"  is  calcu- 
Jated  by  multiplying  the  "  number  treated"  (which  corresponds  too  with 
the  "  aggregate")  by  one  thousand,  and  dividing  the  result  by  the  "  mean 
atrcuglli;"  and  the  "ratio  of  deaths  per  thousand  of  mean  strength"  is 
©btaiued  in  like  manner,  by  multiplying  the  "deaths"  by  one  thousand, 
and  dividing  the^ result  by  the  "mean  strength." 

IX.  In  General  Hospitals,  the  per  centum  of  deaths  occurring  among 
the  "  number  treated,"  will  be  estimated  and  expressed  in  decimals,  car 
ricd  out  two  figures. 

X.  Medical  Officers,  to  whom  any  of  tbcse  reports  are  to  be  rendered, 
or  through  whom  they  are  to  be  sent,  will  examine  them,  and  return  for 
correction  any  that  may  re<juire  it;  or  failing  to  receive  them  in  due  time, 
will  demand  explanation  from  the  delinquent  officers,  and  exact  compli- 
ance with  the  Regulations.  The  Monthly  and  Quarterly  Reports  from 
Medical  Officers  in  charge  of  the  sick  and  wounded,  will  be  rendered 
within  five  days  after  the  expiration  of  the  month  or  quarter. 

It  is  hoped  that  'the  foregoing  brief  explanations  may  enable  Medical 
•  Officers  who  have  thus  far  failed  in  this  important  duty,  to  make  correct 
•nd  reliable  Reports.^  ' 

S.  P.  MOORE, 
'  *  Surgeon  General. 


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